Social Network Norms and HIV Related Drug Use Behaviors Among Homeless Youth

Background: Homeless-youth engage in riskier HIV-related drug use behaviors compared to housed-youth. Studies have shown that these youth’s social-networks are consistently linked with their substance-use behaviors. Social-networks influence behavior through several mechanisms, one of which is through the establishment, and maintenance of social-norms. Norms are defined as perceived properties of a group that characterize specific beliefs around what behaviors are considered acceptable. Network-analyses can be approached at two levels: egocentric (the direct ties of an index person with his or her network members), and sociometric (refers to the complete set of relations in a population, both direct and indirect ties). While several theories suggest that norms offer a potent channel of initiating and sustaining behavioral-change, intervention efforts have been hampered because of the paucity of research examining clustering of norms within specific risk-taking sociometric network structures. This study utilized sociometric-analyses to understand whether social norms of drug-use behaviors are clustered within network-structures and whether these network norms are associated with these drug use.

Methods: Event Based Approach (EBA) was used to delineate the boundary of the sociometric network of homeless-youth, who were all accessing services at two drop-in centers in Los Angeles, CA (n=160) and Santa Monica, CA (n=130). Measures of social norms included 1) perceived substance use by social network members (descriptive norm) and 2) encouragement to engage in substance use from social network members (injunctive norm). Sociometric network characteristics included centrality (measures popularity) and cohesiveness (location within dense sub-networks). The primary behavioral-outcomes were recent methamphetamine and injection drug use (IDU).

Results: Multivariate logistic-regressions revealed that youth who believed that their peers engaged in methamphetamine-use or IDU were 2.5 times more likely to engage in methamphetamine-use and 51.8 times more likely to engage in IDU. Generally, in terms of sociometric network-characteristics, the study found that perception of substance-use behaviors and objections to these behaviors are largely shaped by the cohesiveness in sub-regions of the sociometric network rather than one’s centrality. Specifically, youth who were in more cohesive networks were 4.5 times more likely to report that their peers used methamphetamine and 2 times more likely to report that their peers engaged in IDU.

Conclusion: Results of this study indicate that among homeless-youth, social-norms are clustered within networks. The findings also suggest that interventions seeking to change social-norms among homeless-youth might be effective in reducing drug-use behaviors. However, what these results suggest that peer-based prevention programs for homeless-youth should not rely on popular opinion leaders. The significance of network cohesion within sociometric-network implies that instead of a leader-centric technique, network interventions should be designed to capitalize on the reciprocity and social influence naturally occurring in the denser and more cohesive parts of networks.